初始诊断时年龄小于 60 岁的患者对侧乳腺癌的监测结果。
Outcomes of surveillance for contralateral breast cancer in patients less than age 60 at the time of initial diagnosis.
机构信息
Division of Medical Oncology, Sunnybrook Health Sciences Center, Toronto, ON.
出版信息
Curr Oncol. 2012 Jun;19(3):e160-4. doi: 10.3747/co.19.890.
BACKGROUND
After an initial diagnosis of breast cancer, the risk of contralateral breast cancer is approximately 0.5% per year. Annual mammography is recommended to identify local recurrences and contralateral new primaries. Because the sensitivity of mammography tends to be lower in younger women, we conducted a retrospective review of the method of detection and pathologic stage of metachronous contralateral primary breast cancers according to age at diagnosis in a cohort of breast cancer patients.
METHODS
The Henrietta Banting Database contains information on cases of breast cancer diagnosed at Women's College Hospital from 1987 to 2004. From among 1992 women in the database, 71 patients were identified who were initially diagnosed before age 60 and who subsequently developed a contralateral breast cancer. Medical records were obtained for 53 of the 71 patients.
RESULTS
Of the 53 contralateral cancers, 33 (62%) were detected by mammography, including 4 in 16 patients (25%) diagnosed before age 50 and 29 in 37 patients (78%) diagnosed at age 50 or older (p ≤ 0.001).
CONCLUSIONS
Mammography has poor sensitivity for the surveillance of contralateral breast cancer in early-onset breast cancer patients. Other imaging modalities should be evaluated in this setting.
背景
在最初诊断为乳腺癌后，每年发生对侧乳腺癌的风险约为 0.5%。推荐每年进行乳房 X 线摄影术以发现局部复发和对侧新发原发性乳腺癌。由于在年轻女性中乳房 X 线摄影术的敏感性往往较低，因此我们根据乳腺癌患者队列中的诊断时年龄回顾性地分析了检测方法和异时性对侧原发性乳腺癌的病理分期。
方法
Henrietta Banting 数据库包含了 1987 年至 2004 年在女子学院医院诊断的乳腺癌病例的信息。在数据库中的 1992 名女性中，有 71 名患者在 60 岁之前被诊断出患有乳腺癌，随后又发展出对侧乳腺癌。对其中 71 名患者中的 53 名的病历进行了获取。
结果
在 53 例对侧癌症中，33 例（62%）通过乳房 X 线摄影术检出，其中 4 例发生在 16 名（25%）50 岁之前被诊断出的患者中，29 例发生在 37 名（78%）50 岁或以上被诊断出的患者中（p≤0.001）。
结论
在早期乳腺癌患者中，乳房 X 线摄影术对监测对侧乳腺癌的敏感性较差。在这种情况下应评估其他影像学方法。
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